CPT Code For Basic Metabolic Panel (CPT 80048) | Description & Billing Guide
The CPT code for basic metabolic panel is CPT 80048. This code can be found in the medical procedure category for Disease Oriented Panels or Organs. Basic Metabolic Panel( BMP) tests assess total calcium, sodium, potassium, and chloride levels in the blood, as well as carbon dioxide (CO2), glucose (G6), blood urea nitrogen (BUN), and creatinine levels (Cr).
On the primary metabolism display, chemicals such as calcium (CPT 82310), carbon dioxide, and chloride can be measured (CPT 84520). This CPT code can use to analyze a variety of blood tests.
It is simple to detect early-stage diabetes or renal disease. This code covers laboratory testing, reference intervals, and data interpretation.
Individual test codes can replace with organ or sickness panel codes. Typically, BMP contains eight tests. In addition, several non-Medicare payers have access to panel codes for organs and illnesses.
Rather than using BMPs, your doctor may opt to utilize CMPs to get a complete picture of the condition of your organs or to screen for specific disorders such as diabetes, liver cirrhosis, or kidney disease.
A complete metabolic test (CMP) employs total and albumin proteins and four liver enzymes (ALP, ALT, AST, and bilirubin). CMPs are more expensive. A BMP-like test is a comprehensive metabolic panel.
The CPT code for Basic Metabolic Panel (CPT 80048) can be used for several illnesses, including kidney disease, lung problems, and diabetes-related complications.
In addition to the previously included tests for proteins and liver enzymes, the 12-test CMP panel now consists of 16 measures. As a result, more testing may be required to establish a diagnosis of any abnormal test results.
This test can frequently request in the lab. The CPT code for Basic Metabolic Panel assesses renal function, fluid and electrolyte balance, and blood glucose levels (glucose).
Atypically high or low BMP levels can cause by various health disorders, from kidney disease to respiratory problems to diabetic complications. Therefore, more testing may be required to diagnose abnormal test results.
Non-Medicare payors may establish specific panel codes for diseases or organs. Instead of a different message for each test code, an organ or sickness panel code can report.
Even if you are in good health, doctors may perform the same test on you numerous times, and one of the results may be out of the usual range.
Your readings can vary from day to day due to biological factors. Without a predetermined reference range, ow lessons in a laboratory will be meaningless. A doctor can advise you to retake the test if your results fall outside the approved fields.
Your healthcare expert considers your medical history and past tests when evaluating the results of your BMP.
The results may fluctuate daily and may be outside of the typical range. It may be meaningless if the laboratory lacks a defined reference range to which it must conform. When a test result is slightly above or below the reference range, a doctor may recommend repeating the test and reviewing earlier data from the same experiment.
Only when all the panel components in the specification can finish should the usage of organ- or disease-specific panel codes be considered. Third-party payers can typically assign panel codes to their clients based on organ or condition.
It is crucial to avoid processing delays using the correct procedure code(s) when submitting a claim. Revenue codes that appropriately reflect the services provided must include in claim submissions. The revenue Basic Metabolic Panel (BMP) must be compatible with the connected HCPCS or CPT code.
The basic metabolic panels are calcium (82310), CO2, chlorine (83435), ammonia (82565), glycogen (82477), potash (84132), and salt (84295). (84520).
80048 CPT Code Description
The most fundamental CPT code for basic metabolic panel is CPT 80048 (Calcium, total).
The official description of the CPT code for basic metabolic panel (CPT 80048) is: “Basic metabolic panel (Calcium, total).”
The following elements must include in this panel. The BUN consists of everything listed below:
- Calcium, total (CPT 82310);
- Carbon dioxide (bicarbonate) (CPT 82374);
- Chloride (CPT 82435);
- Creatinine (CPT 82565);
- Glucose (CPT 82947);
- Potassium (CPT 84132);
- Sodium (CPT 84295; and
- Urea nitrogen (BUN) (CPT 84520).
Organ or Disease-Oriented Panels (CPT 80048 – CPT 80076) You cannot submit panel codes for organs or diseases until all of the panel’s components have finished according to the panel’s specifications.
The majority does not require the use of organ or disease-specific panel codes of non-Medicare payers.
It is possible to report individual test codes or to designate a panel of organs or disorders. If a CPT-specified panel of tests can complete, the practitioner can bill either the panel code or the individual component test codes.
Other tests done on the same day of service, in addition to the panel code, may be reported.
When submitting numerous panels, providers must adhere to the CPT coding requirements.
However, because all of the tests in the latter include the former’s essential component, suppliers cannot report both basic panel code CPT 80048 and comprehensive panel CPT 80053 on the same service date.
Medicare has a significant impact on medical test reimbursement policies. When Medicare developed the panels or groupings of automated testing for which it may award financial support in 1998, it indicated that if a single test in a forum is deemed medically necessary, the panel as a whole can justify it.
A single practitioner can put together a “panel” of tests, but this does not indicate that it will reimburse for evidence-based. The number and use of panels can restrict to reduce the amount of unneeded testing.
Basic Guidelines
Unless the panel with the maximum number of tests that fit a specific code specification is necessary, a collection of tests that spans numerous committees can benefit from particular test codes. Only approved and required tests should include on the board.
A laboratory panel or a chemical panel is a group of tests ordered for one person on a specific day. Medical coding firms hire billing criteria and code experts for laboratory panel operations and individual components.
They should not consider clinical parameters, even though they will develop for coding purposes. The components of each panel will specify by United Healthcare Community Plan utilizing CPT coding standards.
“Do not record two or more panel codes that incorporate any equivalent constituent tests from the same patient collection,” according to the Professional Edition of the CPT® book. Calcium, CO2, chloride, creatinine, glucose, potassium, sodium, and urea nitrogen should test using the CPT code BMP 80048 for automated multichannel testing (basic metabolic panel).
Regardless of how well you believe you are doing, a doctor may run the same exam on you repeatedly and find a result outside the usual range. In addition, your readings may vary from day to day due to biological factors.
It is unnecessary to submit CPT 80048, CPT 82310, CPT 82374, CPT 82435, CPT 82665, CPT 82947, 82948-C, CPT 84132, CPT 84295, CPT 84520, and CPT 84295-C. These companies are aware of the most current reporting rules for screening diagnosis codes and laboratory test codes.
By contacting their insurance providers and employers, they can receive the most up-to-date and accurate information when invoicing and coding screening blood tests. In addition, they may be able to assist in obtaining suitable funding for laboratory panel tests and individual component therapy.
CPT 99281 – CPT 99285 are emergency department service codes that describe the E/M services offered in the ED and require a record of the patient’s history, examination, and physician opinion.
CPT Code For Basic Metabolic Panel & Modifier 91
The modifier used for the CTP code for Basic Metabolic Panel (CPT 80048) is modifier 91.
Even when a claim can submit in its entirety, we are all aware of how difficult it can be to get payers to pay. If you neglect to make even one alteration, you will have to go through a lengthy process of resubmitting claims, modifying them, and appealing them.
Having exact coding knowledge on your side is critical to getting your claims and services paid. Modifier 91 is a repeat clinical diagnostic laboratory test described by CPT to obtain new test results throughout therapy.
It goes without saying that when billing for the same CPT twice or three times a day for the same patient, it is critical to add the appropriate modifiers.
While modifier 91 is only used for laboratory testing and provides the most accurate billing, modifier 59 can be. In most lab situations, modifier 91 should be used instead of modifier 59 when another code would more appropriately describe a sequence of lab tests.
Reimbursement For The CPT Code For Basic Metabolic Panel
Reimbursement is possible for the CPT code for basic metabolic panel (CPT 80048) if the instructions given by a doctor or other trained practitioner regarding the test’s purpose have been recorded.
United Healthcare Community Plan deviates from the CPT book’s requirement that an organ or Disease-Oriented Panel contain a certain number of Component Codes for reimbursement purposes.
Medical records must preserve. The presenting symptoms, diagnoses, treatment plan, and a written order from the provider must include in the member’s medical record documentation for diagnosis and treatment in the ED.
In addition, medical records and itemized bills from the institution or provider must seek to verify the quality of care and services billed.
Examples
A patient who is 65 years old has a diabetic disease with ketoacidosis. A series of blood tests evaluated potassium supplements and low-dose insulin therapy on a 65-year-old diabetic.
Three further blood tests would arrange and perform on the same day as the potassium dose to correct the patient’s hypokalemic state.
